[Central and peripheral circulation in patients after orthotopic transplantation of the heart].

J Fabián, J Horák, I Prerovský, M Petrasko, V Kocandrle

Vnitr Lek 1989, 35(4):313-324

Heart transplantation in human medicine is a unique model which makes it possible to study circulatory changes in complete denervation of the heart. The authors examined repeatedly the central and peripheral haemodynamics after orthotopic heart transplantation (OTS) in 11 patients (11 males, 1 female; mean age 44 +/- 4 years) following an interval of three months to four years after the operation. The values of central haemodynamics at rest varied in the majority within the normal range. After a load, in patients after OTS the heart rate rises only slowly. There is an abnormal rise of the filling pressure in both ventricles which leads also to an abnormal...

[Topography of foci of perfusion defects after myocardial infarct on standard ECG and thallium stress scintigraphy].

J Kasalický, J Kidery, B Vavrejn, I Málek, V Staněk, I Stolz

Vnitr Lek 1989, 35(4):325-332

65 patients after previous myocardial infarction well documented by electrocardiography were investigated by 201-Tl scintigraphy after submaximal ergometry. Topographic results of the scintigraphy in three planes were compared with the location of previous infarction demonstrated by standard electrocardiography. 30% of disagreements and partial agreements in more than half the patients were caused predominantly by inability of electrocardiography to qualify a true ischaemic necrosis in the interventricular septum, by limited ability to localize exactly the site of myocardial infarction and by underestimating its size, in particular in the posterior...

[Hyperlipoproteinemia, risk indicators and ischemic heart disease].

O Kusá, O Luknárová, I Riecanský

Vnitr Lek 1989, 35(4):333-339

The authors analyzed the incidence of risk indicators in a group of 120 men with ischaemic heart disease, type stable angina pectoris, with a positive coronary score in a group of 30 men with a negative coronary score. The mean age of the probands was 35 +/- 7.539 years, in men of the control group 42.1 +/- 8.891 years. The mean number of risk indicators in the group of probands was 4.9 +/- 2.100, in the control group 1.7 +/- 1.067 (p less than 0.001). The highest number of risk indicators was found in probands with the phenotype of hyperlipoproteinaemia IIb - 5.4 +/- 0.756, as compared with 4.8 +/- 0.861 in probands with the phenotype of hyperlipoproteinaemia...

[Thrombosis and thromboembolism in patients with a Björk-Shiley prosthesis].

V Hricák, M Kovácik, V Fridrich

Vnitr Lek 1989, 35(4):340-343

Thrombosis and thromboembolism are, in addition to left ventricular function, the basic factors which deteriorate the score and long-term prognosis in patients with valvular prostheses. The authors analyze the problem of thrombosis and thromboembolism in 261 patients with Björk-Shiley's prosthesis who were operated during the last five years. The authors consider as the main risk factors in the first place inadequate anticoagulation treatment, the position of the implant in the mitral orifice, the type of valvular implant and atrial fibrillation. The authors present a brief account of successful thrombolysis of a thrombotized Björk-Shiley prosthesis...

[Repeated ergometric loading].

M Kozáková, J Petrtýl, V Tesar

Vnitr Lek 1989, 35(4):344-351

The action of cardioactive substances is tested by repeated ergometric loads. The aim of the present work was to assess whether after previous loads in the organism certain adaptational changes persist, cardiovascular, respiratory or metabolic, which might influence the course of a subsequent load. The authors exposed therefore two groups of patients to identical loads after 2- or 24-hour intervals and investigated the behaviour of some spiroergometric indicators. From the results ensued that a load repeated after 2-hour intervals takes place under different conditions. In this participates probably the increase of the a-v difference for oxygen and...

[The relation of myocarditis to the development of cardiomyopathy].

V Kováliková, J Gvozdják

Vnitr Lek 1989, 35(4):352-357

Dilated cardiomyopathy is a degenerative disease of the myocardium of unknown etiology. Evidence was provided in experiments on mice that it may develop as a late consequence of viral myocarditis. In experiments on mice it was also found that the damaging factor in the pathogenesis of myocarditis may be a reaction of the immune system rather than an infective agent. Research into myocarditis and dilated cardiomyopathy in humans is faced with the difficulty of accurate assessment of the diagnosis; frequently there is no sharp borderline between the two conditions. The possible pathogenetic role of immune reactions is apparent from several publications--the...

[Duplex ultrasonic examination of arteries of the lower extremities--comparison with angiography].

M Demes, A Soka, M Dúbrava, M Kostolný

Vnitr Lek 1989, 35(4):358-362

The authors compared the results of duplex ultrasonic examination of 86 sections of the ileo-femoro-popliteal portion of the arterial circulation with angiographic findings. The correlation between angiographically and ultrasonically assessed degrees of stenosis was close and highly significant (r = 0.895, p = 0.001, y = 0.782x + 17.382). The sensitivity of duplex sonography when assessing significant stenoses (60% of the arterial lumen or more) was 100%, the specificity 76.5%, the probable positive value 75%, the probable negative value 100%, the probable positive ratio 3, the reliability of the test 86%. With regard to these results the authors recommend...

[The effect of passive smoking and alcohol on cardiomyocytes in rabbits].

A Gvozdjáková, J Kucharská, J Gvozdják

Vnitr Lek 1989, 35(4):363-369

The authors investigated the action of two weeks' simultaneous action of passive smoking (breathing the smoke of three cigarettes for 30 minutes twice a day) and alcohol (5 ml 20% ethanol per 1 kg body weight s.c. twice a day) on the vitality of isolated myocytes of the rabbit heart muscle. The vitality of cardiomyocytes was evaluated using morphological (microscopic examination of the shape of isolated cardiomyocytes) and metabolic criteria (oxygen uptake by isolated cardiomyocytes from the medium in different substrates--glutamate, pyruvate and succinate). The authors compare the assembled results with previous investigations of the isolated effect...

[Early acute tubulointerstitial nephropathy in transplanted kidneys].

V Herout, J Erben, P Fixa, J Zahradník, B Hájková

Vnitr Lek 1989, 35(4):370-375

The authors investigated in a group of 124 patients the effect of acute tubular nephropathy and rejection on the period of functional persistence of transplanted kidneys. Transplants which developed tubulointerstitial nephropathy during the first two weeks after transplantation of the kidney had significantly lower cumulative indexes of survival for as long as the second year after transplantation. Grafts which were rejected during the first two weeks after transplantation had a significantly lower cumulative survival index only during the first and second year. The statistical significance was always tested in comparison with grafts where the postoperative...

[The importance of enteroclysis in Crohn's disease].

Z Antos, J Horák, M Vasícek

Vnitr Lek 1989, 35(4):376-381

The authors discuss the importance of enteroclysis in Crohn's disease. In a group of 22 patients the finding was negative only in four where the primary localization of the disease was beyond the small intestine. In the remaining patients enteroclysis either confirmed the extent of the affection assessed during irrigoscopy or more frequently revealed a more extensive affection of the small intestine than was originally assumed, provided evidence of an affection not revealed by other methods, drew attention to imminent obstruction or another serious complication and in two instances established the diagnosis. Enteroclysis in Crohn's disease is a valuable...

[The effect of Biston on cardiac dysrhythmias].

I Lazúr

Vnitr Lek 1989, 35(4):382-388

The author treated in 1983-1987 88 patients with different cardiac dysrhythmias with Biston, Spofa. It was most effective in ES arrhythmias. It was also effective in ES arrhythmias grade IV-V according to Lown, even where previously various antiarrhythmic drugs were tested with a small or no effect. After its administration atrial fibrillations receded also; it did not prove possible, however, to convert chronic atrial fibrillation to a sinus rhythm. The drug was less effective in supraventricular paroxysmal tachycardia. With regard to its low toxicity, minimal side effects, availability and price, the author recommends its wider use in antiarrhythmic...

[Eosinophilic leukemia].

J Voglová, L Chrobák, Z Kerekes, D Radochová, J Spacek, P Balícek

Vnitr Lek 1989, 35(4):389-394

On the example of a patients with eosinophil leukaemia, which at first was manifested as eosinophilia in the peripheral blood stream and bone marrow without involvement of other organs and only after three years acquired the character of malignant growth, the authors draw attention to difficulties in the differential diagnosis of hypereosinophil syndrome. At the same time the authors review briefly views on the origin of eosinophil leukaemia, morphological and cytogenetic findings considered useful as evidence of this rare type of leukaemia.

[Experience with the introduction of anti-HIV antibody testing in the transfusion service].

R Kofránková, J Urbanová, V Veselý

Vnitr Lek 1989, 35(4):395-397